Most Relevant Information
Provider Data
| NPI Number: | 1003362708 |
| Provider Name: | TRACI LEWIS |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/01/2016 |
| Last Updated: | 01/31/2023 |
Provider Practice Location
919 LAWYERS LN
COLUMBUS
GA
319063129
Practice Location Phone/Fax
| Phone: | 7062563200 |
| Fax: |
Provider Mailing Location
2018 14TH ST APT B
PHENIX CITY
AL
368675434
Provider Mailing Phone/Fax
| Phone: | 7066179781 |
| Fax: |